A myelogram, also known as myelography, is a diagnostic imaging procedure performed by a radiologist. It combines the use of a contrast substance with X-rays or computed tomography (CT) to evaluate abnormalities of the spinal canal, including the spinal cord, nerve roots, and other tissues.
The contrast "dye" is injected into the spinal column before the procedure. This substance, or dye, causes the tissue under study to be visible.
After the contrast dye is injected it appears on an X-ray screen allowing the radiologist to view the spinal cord, subarachnoid space, and other surrounding structures more clearly than with standard X-rays of the spine.
The radiologist will also use a CT scan when performing a myelogram. A CT or CAT scan is a diagnostic imaging procedure using a combination of X-rays and computer technology to produce cross-sectional images both horizontally and vertically across the body. These images, called slices, show detailed images of the spinal canal. CT scans provide more detail than standard X-rays.
The spinal column is made up of 33 vertebrae that are separated by spongy disks and classified into distinct areas.
The spinal cord, a major part of the central nervous system, is located in the vertebral canal and reaches from the base of the skull to the upper part of the lower back. The bones of the spine and a sac containing cerebrospinal fluid surround it. The spinal cord carries sense and movement signals to and from the brain and controls many reflexes.
A myelogram may be performed to assess the spinal cord, subarachnoid space, or other structures for abnormalities, particularly when another type of examination, such as a standard X-ray, is inconclusive. Myelograms may be used to evaluate many diseases, including, but not limited to, the following:
There may be other reasons for your doctor to recommend a myelogram.
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your doctor. Radiation exposure to the fetus may cause birth defects.
Because a contrast dye is used during the procedure, there is risk of allergic reaction to the substance. Studies show that 85 percent of the population will not experience an adverse reaction from iodinated contrast; however, you will need to let your doctor know if you have ever had a reaction to any contrast dye, and/or any kidney problems. A reported seafood allergy is not considered to be a contraindication for iodinated contrast.
Because the contrast is injected into the cerebrospinal fluid which also surrounds the brain, there is a small risk of seizure after the injection. Some medications may place you at greater risk for seizure and you may be asked to stop taking a medication for 48 hours before and after the study.
Because this procedure involves a lumbar puncture, the following potential complications may occur:
A myelogram may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, a myelogram follows this process:
You may experience discomfort during the myelogram. The radiologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
You should remain in the sitting or laying position for several hours after the procedure to reduce your risk of developing a CSF leak.
You will be asked to drink additional fluids to rehydrate after the procedure. This helps to replace the spinal fluid that was withdrawn and reduces the chance of developing a headache.
A nurse will monitor your vital signs (blood pressure, temperature, pulse, and respirations) frequently after the test. Analgesic agents may be administered if you develop a headache.
When you have completed the recovery period, you will be taken to your hospital room or discharged to your home.
Once you are at home, notify your doctor of any abnormalities, such as numbness and tingling of the legs, blood or other drainage from the injection site, pain at or near the injection site, inability to urinate, fever, stiff neck, or headaches. If the headaches persist for more than 24 hours after the procedure, or when you change positions, you should contact your doctor.
You may be instructed to limit your activity for 24 hours following the procedure. Generally, if no complications occur, you may return to your normal diet and activities.
Your doctor may give you additional or alternative instructions after the procedure, depending on your particular situation.
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